A common cause for displacement of the azygoesophageal recess is a hiatus hernia.

This patient had a barium swallow that showed a 8.5 cm diameter sliding hiatus hernia with a 4.6 cm widening of the lower esophagus, along with spontaneous gastroesophageal reflux and signs of esophagitis.

She was treated by Nissen's fundoplication after conservative treatment failed.